HUMAN IMMUNODEFICIENCY VIRUS (HIV)


The human immunodeficiency virus, more commonly known as HIV, is a virus that damages the CD4 cells of the immune system. The immune system which is the body's defence against infection is then weakened by the virus and the body is unable to fight off infections. HIV may progress to acquired immunodeficiency syndrome, commonly known as AIDS, if the immune system is fully compromised. This condition is life-threatening as the immune system is so compromised that opportunistic infections take over the body.

Luckily, HIV does not have to progress to AIDS. If the HIV is managed, with antiretroviral therapy (ART) before the CD4 count is too low, and a healthy lifestyle is maintained, people with HIV can go on to live a purposeful life. Dr Mogambery is a subspecialist in infectious diseases with over 4 years of experience working primarily with HIV infected patients. Having spoken at two SA HIV Clinician conferences as well as presenting at an international AIDS conference in 2015, and having been a trainer for CAPRISA's advanced clinical care courses held in KwaZulu-Natal for roughly 3 years, she has extensive insight in this regard. Aside from aiding patients in suppressing their HIV viral load and managing their condition to prevent progression, Dr Mogambery also assists those with complications or side effects from antiretroviral therapy (ART).

Because HIV attacks the immune system, infections that are usually benign become quite serious. These are called opportunistic infections, and the common ones include tuberculosis (TB), cryptococcal meningitis, candidiasis, cryptosporidiosis, cytomegalovirus, wasting syndrome, and neurological complications like depression, anxiety and dementia. As a physician well-versed in infectious diseases, constantly keeping in line with current trends in HIV management, Dr Mogambery is able to aid those with complex HIV infections and complications. Passionate about assisting in the management of this condition, she also wishes to collaborate with other general practitioners and physicians with these patients.

Opportunistic diseases and long-term sequelae of HIV infection

The immune system, which is the body's defence against infection, is weakened by HIV. When the immune system is fully compromised, and the CD4 count is disastrously low, the person is diagnosed with AIDS. The immune system is at this point so compromised that opportunistic infections may be life-threatening if not treated.

Opportunistic infections such as tuberculosis (TB), fungal infections, pneumonia or meningitis often plague those with HIV or AIDS. Dr Mogambery is not only able to treat these infections but assists in managing HIV infected patients by commencing antiretroviral therapy (ART) early enough to prevent further infections and complications.

In some cases, those infected with HIV, have extremely low CD4 counts before beginning antiretroviral therapy (ART). After the medications begin to work, the immune system may get better very rapidly. All the infections that have been lying latent in the body are now recognised by the recovering immune system, and the overwhelming immune response may result in serious illness. When the patient becomes ill due to this phenomenon, it is called immune reconstitution syndrome. While latent infections such as TB, viral infections or organisms that cause meningitis are now being fought off, this syndrome can be life-threatening. Dr Mogambery is highly experienced in treating and managing infections among such patients. Furthermore, she has the expertise to treat complications related to HIV and AIDS such as hypertension, dyslipidaemia and diabetes, as well as screening for malignancies for which those with HIV have a high prevalence and risk.